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Abstract

Escherichia coli is the predominant isolated type of bacteria in urinary tract infections in children. Multidrug resistance of this kind of infection is associated with an increased risk of kidney injury and, therefore, an increase in morbidity and mortality. This report presents a case of a 6-year-old child with recurrent pyelonephritis with multidrugresistant E. coli. She was followed, in a teaching hospital and was successfully treated with daily cephalexin prophylaxis for about four years as a result of the collaboration of healthcare providers. Continued teamwork between health care providers, especially collaboration between the treating pediatric nephrologist and the clinical pharmacist, yielded better decisions to overcome the multidrug-resistant bacteria over the course of the disease in such a vulnerable child patient. This case lends support for the use of suppression therapy in pediatric patients with severe recurrent bladder and renal infections as well as support for the patient-centered approach in achieving improved pharmacotherapy and patient outcomes.